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DME MEDICAL SUPPLY AND OTC PRODUCTS ONLINE STORE

P.O.Box 7185 Deerfield IL United States 60015

PKU Oral Supplement Lophlex® Tropical 4.2 oz./1.2 mL Pouch Ready to Use CS/30

Availability: Discontinued, Please use #86052600

LOPHLEX LQ 20 MED FOOD S/B 30EA/CS DMF NUTRITION.

Nutricia North America
$428.09

$428.09 per CS/30

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  • Lophlex Lq 20 Med Food Cs/30 Dmf Nutrition
  • A phenylalanine-free, ready-to-drink medical food containing amino acids, vitamins, trace elements and some minerals for the dietary management of proven Phenylketonuria (PKU) in individuals 4 years and older including pregnant women and women of child-bearing age
  • Provides 20 g of protein equivalent in one pouch
  • HCPCS SUGGESTED CODE B4157 OR B4162
  • Application medical food powder
  • Container Type pouch
  • UNSPSC Code 42231803
  • Flavor tropical
  • Calories per Serving 116 calories
  • Container Size 4 2 oz 1 2 ml
  • Preparation Ready to Use
  • Brand Lophlex®
  • HCPCS Code Description
  • B4157 - Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4162 - Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

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